Thrombocytopenia during pregnancy

Thrombocytopenia in pregnancy - definition

Thrombocytopenia is an insufficient number of blood platelets or thrombocytes. Their main function in the body is to clot the blood. If there are too few platelets, this can lead to clotting disorders such as excessive bleeding.

Thrombocytopenia is diagnosed during a routine blood count, which is carried out on every pregnant woman every four weeks. A platelet count of less than 150,000 is considered a diagnosis of thrombocytopenia. It is important to carry out diagnostic tests and determine the cause.

Thrombocytopenia during pregnancy - causes

Most commonly, thrombocytopenia in pregnancy is associated with an increased plasma volume and is referred to as gestational thrombocytopenia. It is not usually associated with serious complications or the risk of perinatal haemorrhage. Thrombocytopenia in pregnancy is also a symptom of pre-eclampsia and HELLP syndrome. It is then often accompanied by high blood pressure or elevated liver values. Thrombocytopenia can also occur in the context of intravascular coagulation and von Willenbrandt disease.

Thrombocytopenia in pregnancy - treatment

When diagnosing thrombocytopenia during pregnancy, an attempt is always made to determine the cause. The doctor asks the pregnant woman about possible symptoms and previous thrombocyte problems. In addition, a diagnosis of viral hepatitis or cytomegalovirus and a manual blood smear are carried out. It is also advisable to take a blood sample with citrate to rule out pseudothrombocytopenia. If pre-eclampsia is suspected, the expectant mother should have her blood pressure measured regularly and have tests such as creatinine, ALT or AST and a general urine test for proteinuria carried out.

Thrombocytopenia in pregnancy - Delivery

The decision on the method of delivery depends on the individual obstetric situation. Thrombocytopenia alone is not an indication for a caesarean section. However, if it is a symptom of HELLP syndrome, an urgent termination of pregnancy is essential. The platelet count is particularly important for anaesthetists during labour. Values below 70-80,000 are considered a contraindication for subarachnoid or epidural anaesthesia. However, the decision on anaesthesia is always made individually by the anaesthetist.